The Prevalence of HIV and Transmission Risk Factors among Hepatitis B and C Patients Referred to Emam Reza Hospital, Mashhad, Iran from 2005-2008

Hepatitis B and C infections have remained major global health burdens during the most recent century. The viral agents responsible for these diseases share common modes of transmission with human immunodeficiency virus (HIV) such as needle-sharing in IV drug abusers. Coinfection of hepatitis B or C with HIV increases the rate of progression of chronic liver disease. Given the lack of data in Iran, in particular Khorasan Razavi Province, with regards to this coinfection, the present study evaluates the frequency distribution of hepatitis B and C coinfection with HIV infection and their modes of transmission. This was a retrospective study based on available data at the Gastrointestinal and Liver Diseases Center, Emam Reza Hospital, Mashhad, Iran. We used questionnaires to collect demographic data from 749 patients infected with hepatitis B or C who refered to this clinic between 2005 and 2008. The available sera of these patients were tested for the coexistence of HIV infection with hepatitis B or C infections. The results were analyzed with SPSS version 16 software. From 749 patients infected with hepatitis B or C viruses, 650 were infected with hepatitis B (64.9% male and 35.1% female). There was no HIV antibody detected in any of the patients'' sera who had hepatitis B infection. Among the 106 patients with hepatitis C infection (84% male and 16% female), only one (0.9%) who was an IV drug abuser tested positive for HIV infection. Hepatitis B/hepatitis C coinfection was found in 7 (0.9%) patients. With regards to the risk factors of viral transmission among those with hepatitis B infection, the most common was a positive family history of hepatitis B (37.2%). Other risk factors in order of decreasing frequency included a history of venesection and tattooing (13.8%), transfusions (7.1%), IV drug abuse (2.6%), needle stick accidents (2.3%), and high-risk sexual activity (0.6%). In those with hepatitis C infection, a history of IV drug abuse was the most common risk factor (40.6%), followed by a history of transfusions (28.3%), venesection or tattooing (16%), surgery (13.2%), needle stick accidents (4.7%), hepatitis C infection in a family member (2.8%), and unsafe sexual contact (0.9%). There was a significant difference in the transmission risk factor ratio between hepatitis B and C patients (p=0.001, χ2=261/590) The most common risk factor for transmission of hepatitis B and C infections in patients who presented to Emam Reza Hospital, a referral center in Mashhad, was a positive family history of hepatitis B infection and IV drug abuse, respectively. The prevalence of HIV coinfection amongst patients with hepatitis B or C infections was low. However, further studies with larger populations are required.